Technology Assisted Prog Mgr
5 months ago
Employment Benefits
Comprehensive medical, mental, dental, vision, and additional coverage
Sick & Vacation leave
Work-Life Balance programs: parental leave, military leave, jury leave, funeral leave
Paid State Holidays (designated by the Governor annually)
Fitness Centers in select locations
Employee discounts with the
Retirement and deferred compensation programs
Position Summary & Responsibilities
This position is responsible for administering and managing the Technology Assisted (TA) waiver program. This position is primarily responsible for the design, development; management and oversight of program goals, policies, procedures, objectives, grievances and appeals for the TA program within agency or regulatory guidelines. Additionally, this position involves making changes to program laws and requirements as the program evolves.
Job Responsibilities may include but are not limited to the following:
Program Administration- TA Waiver
The incumbent develops and interprets regulations, policies and procedures pertaining to this waiver, then develops and implements protocols for program management and service delivery. The incumbent provides technical assistance on statutes, regulations, and program policies and procedures to contracted entities, providers and stakeholders, then develops, implements, and monitors processes to manage the TA program.
Developing, researching, and preparing responses to address media and legislative inquiries and the public's requests concerning agency procedures and applicable laws for KDADS leadership; addressing and responding to complex provider and participant issues, concerns, and special requests to ensure timely responses to complaints, grievances, appeals, questions and inquiries; ensuring issues are resolved according to applicable policies and procedures and documented to support responses.
This position is responsible for planning, organizing, directing and managing the Technology Assisted (TA) program. Maintains day-to-day management of programmatic activities to effectively oversee program administration, reviews access and exception requests and approves or denies based on criteria. Acquires necessary knowledge to develop, design and implement an effective quality program. Responsibilities include the following:
Amends and renews the federally approved programs in accordance with CMS guidance and regulations; submitting applications via the CMS portal in federally mandated timeframes; responding to requests for information (formal and informal) from CMS and KDADS leadership; conducting public comment sessions and summarizing feedback for CMS review; ensuring final approved documentation is posted publicly and updated as appropriate. Ensures timely submission of renewals, amendments, and other applications to the appropriate federal authorities, and responds to CMS requests for additional information to ensure federal financial participation match funds will be available to continue program operations and the match to State General funds is appropriate to meet program needs and state or federal mandates. Directs and consults contracted health plans regarding TA program policies, procedures and regulations and confers with leadership and the HCBS team to explain, interpret and discuss programs, laws, rules, regulations, policies and other directives. Works with different entities to address issues, grievances, concerns, and appeals within required timeframes; forwards cases of abuse, neglect, exploitation, Medicaid fraud, waste and abuse to Quality Management Specialists and the Program Integrity Team for review and follow-up as appropriate. Reviews adverse incident reports and assigns responsibility for follow up to the appropriate program field staff. Develops and establishes performance measure criteria for monitoring and oversight of program operations to ensure the program is compliance with or operating within Centers for Medicare and Medicaid Services (CMS) regulatory requirements. The incumbent will collaborate and actively participate in the program quality monitoring activities of the quality assurance team. Works KDADS and KDHE staff to address concerns with MCO service delivery related to the TA program. Assists with Corrective Action Plan (CAP) development and monitoring in the event of vendor non-compliance. Assists the Quality Management Specialist (QMS) to confirm that performance measures are being met and provides technical assistance and information according to policies; participates in the design, development and implementation of program performance measures Participates with the Quality Management Specialist and Program Integrity in the review, remediation and response to critical incidents, abuse neglect and exploitation, fraud, waste, and abuse, and special questions and issues related to the TA program that may impact the health and welfare of participants served by this program. Prepares agency responses, documentation and reports, programmatic overviews and attends/serves as a witness for State Fair Hearings as the subject matter expert as required. Participates in education, training, and collaboration with, and provides technical assistance to, the contracted managed health plans and other subcontractors to assist and guide contractors through program policies and procedures. Ensures clinical or functional eligibility assessment contractors follow policies, procedures and protocols to document eligibility decisions and retain copies of client information, financial, psychological, medical, court and assessment documentation to provide accountability for subcontracted administrative tasks. Leading, directing, facilitating and attending internal and external meeting with agency staff, contracted entities, providers and others as necessary; responsible for leading stakeholder engagement activities and workgroups for the TA waiver. Utilizes management systems and tools to address special concerns and issues; continually improves program services and procedures; determines whether needs are being met; initiates changes to correct deficiencies; and adapts programs and services to meet changing needs.Data Analysis:
This position performs programmatic and administrative duties such as reviewing, analyzing, and evaluating all required reports using outcome and service encounter data and provides it to identified federal and state partners. Reviews, analyze and approve management reports, case files, procedural expectations and other materials related to complaints, appeals and fraud to determine propriety of actions; evaluates and makes recommendations concerning the need for new and revised statewide policies and programs; prepares and maintains necessary records and required reports on program and quality management.
Incumbent reviews daily, monthly, and quarterly reports on contractor performance, then formulates proposed solutions to problems related to the provision of effective and efficient services. Afterwards the incumbent verifies the solutions improve positive outcomes and quality of life of TA participants receiving HCBS services.
Contract Monitoring/Oversight
Responsible for development and monitoring of TA grants and contracts. This includes developing scope of work, monitoring financial and program reports and monitoring program outcomes for effectiveness.
Other duties as assigned:
The Program Manager supports other HCBS team members in providing program support and technical assistance for other programs.
Minimum Requirements :
3 years of experience working in this specific field, may be substituted for formal education as determined relevant by the agency. Occasional travel may be required.Preferred Requirements:
At least 3 of years’ experience with the pediatric medically fragile population. Experience with programs and services for disabled populations. Experience in a health care setting/medical field, Medicaid HCBS Programs, or Managed Care Health Systems. Experience in program management. Ability to organize, evaluate, direct, and facilitate the work of groups and individuals. Experience with Word, Excel and PowerPoint with proofreading, editing and attention to detail. Ability to understand, interpret and apply Federal laws and State statutes/regulations. Excellent interpersonal/public relation skills and ability to express oneself clearly and effectively, both in writing and orally. Experience in the design, development and presentation of program/work-related information to a public audience. :-
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